Trends for Tuberculosis Treatment Outcomes, New Sputum Smear Positive Patients in Kwekwe District, Zimbabwe, 2007-2011: A Cohort Analysis

摘要

Introduction: Tuberculosis remains a public health problem in Zimbabwe. Understanding the treatment outcomes is an important proxy indicator on the performance of the tuberculosis program. This study analyzed treatment outcomes of new sputum smear positive tuberculosis patients in Kwekwe district. Materials and Methods: A retrospective records review of new sputum smear positive tuberculosis patients registered in the district tuberculosis register in Kwekwe was conducted. Treatment outcomes were categorized according to the national tuberculosis control program and multivariate logistic regression model was used. P values less than 0.05 were considered statistically significant. Results: From a total of 1115 new sputum smear positive tuberculosis patients, cure rate ranged from 40.8% to 62.8% and death rate of patients decreased from 11 (8.0%) in 2007 to 17 (5.3%) in 2011 (p = 0.016). However, defaulter rate increased from 10 (7.3%) in 2007 to 30 (9.3%) in 2011. In multivariate logistic model, HIV positive tuberculosis patients were more likely to experience (adjusted RR = 1.84, 95% CI: 1.10 - 3.08) unfavorable treatment outcome when compared to negative counterparts. Urban residents were also at risk 1.91 (95% CI: 1.14 - 3.20) unfavorable outcome compared to rural residents. Conclusion: The cure rate was low (ranged from 40.8% to 62.8%) and the defaulter rate needed urgent attention. The district should conduct defaulter tracing and follow up.